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10 JIP <br /> GROUNDWATER SAMPLE COLLECTION DATA FORM <br /> SAMPLE LD NO I"W- 3 WELL NUMBER: W -03 <br /> DATE/TIME 13L2 WEATHER: (2111=_,,TG <br />' ANALYSIS. ZZ 14 1, X } - a 6 cH ar a -�y.c b <br /> WELL PURGING DATA. D$ FILTERED? Yes l�J <br /> Initial depth to water. / Filter Device: In-line <br />' Depth of well: X9. 25 , Filter barrel <br /> Volume of water in well. 21, 355!9/- Lab <br /> Date/time at start of purging- 13 o0 Other <br /> 1 Method of purg-ing: 24,!t. <br /> Method of Decontaminata.ng <br /> purging equipment: <br /> Zen t-A Q X M,IQ <br /> WATER QUALITY OBSERVATIONS DURING PURGING: <br /> Volume 1 Depthto H EC Umhas Turbidity <br /> Date/time purged water Tem -OFF p <br /> Irl , o 2. .;2 <br /> 47 gig <br />■" - 0 , 0l 017 <br /> ' �� , 7 >, <br /> r <br /> 1 <br /> SAMPLE CONTAINER DATA: SAMPLE METHOD: <br /> Bum <br /> Number/type of container: ail <br /> ther- <br />' VOA capacity- 4e,m/ <br /> preserve- <br /> Amber capacity, <br /> preserve: <br /> Plastic capacity- e;-cc ,n r <br />' preserve: <br /> Other (des 'be). <br /> SAMPLE PRESERV N METHOD. <br /> Iced her (describe). <br /> Signature: Date/Time: <br />' Prgpd 1051 Match 1991 <br />